Bad Faith Insurance Attorneys
Personal Injury Lawyers - Representing People Nationwide
Insurance companies' revenue comes from the premiums you pay, and their expenses are their operating expenses plus what they pay out in benefits. Even if an insurance company makes no profits, it is still bringing in more money in premiums than it is paying out in benefits. Your premiums pay the salaries of all their employees from the telemarketer to the top executive. However, insurance companies are making profits, record profits. The industry posted profits of over $44 billion in 2005, despite payouts for the major hurricanes Katrina, Rita, and Wilma. And their profits grew by $15.6 billion in the first nine months of 2006, and have only continued this year.
Although insurance companies deny some claims with good reason, sometimes they deny claims as part of an attempt to cut costs and increase profits. If you have been inexplicably denied if you were led to believe that you would be covered, or if your claim has been delayed without explanation, you may be facing this very practice.
If this is the case, you just might be a victim of bad faith insurance practices. The law mandates that you should receive good faith and fair dealing from your insurance company, but the companies do not always provide it. You might be experiencing bad faith insurance practices if any of the following are true:
- They offer you a settlement far below your damages
- Your insurance company seems to be looking for an excuse not to pay for catastrophic injuries clearly spelled out as covered in your policy.
- They tell you your policy means something other than it seems to say.
- They are extremely slow to respond for a routine claim like an auto accident.
- They are vague about what provisions do or do not apply in your case
If your insurance company is acting in bad faith, can a lawyer help? Yes! But your lawyer will be most effective if you take certain steps to make sure you are complying with the law's guidelines.
Good faith and fair dealing standards
First, understand the expectations placed by the law on your insurance company. To be considered acting in good faith, your insurance company must:
- Cooperate with you to properly adjust the claim
- Adjust your claim in a reasonable time period
- Tell you in writing why it is denying the claim with reference to specific contract terms or previsions used to make the decision
- Begin with the assumption that the claim should be paid rather than simply looking for reasons not to pay it
- Conduct fair practices with you, meaning that it must:
- Set up reasonable times for inspection of claim sites
- Try to get all necessary information it needs in as few statements as possible
- Attempt to clarify, not confuse, the terms of your policy
- Keep you informed at all times of the progress of your claim
Second, your case might be damaged if you do not also must remember that good faith is a two-way street. Your claim can be damaged if the insurance company can pin misconduct on you. To avoid such charges, you must:
- Submit your claim quickly
- Answer all reasonable questions truthfully and thoroughly
- Give a statement concerning the loss under oath, if asked
- Make yourself available at reasonable times to give additional statements
- Keep appointments you make for meeting with your insurance company
If you’ve done your part, but it doesn't seem to be getting you anywhere, it's time to consult a bad faith insurance lawyer.
The Write Stuff
Just because you're consulting with a lawyer, doesn't mean you should stop working to get results on your own. However, the most important thing to remember is: get everything in writing. Keep records of the insurance company’s decision, your claim, and any statements you’ve made. Even if the insurance company seems to have a good reason for denying your claim, don’t give up if you've been led to believe you'd be covered in the circumstances you are in. Courts favor interpretations that imply payment rather than denial of claims, especially if you can say how you were led to believe you had coverage during the sales process.
Keep gathering information and maintain lines of communication. Find out the names of your claims adjuster, their supervisor, and their supervisor, if necessary. Also, make sure everything you send to the insurance company is politely and professionally written, especially any complaint letters. Work your way up the chain of command from the adjuster, then (if that doesn’t receive action) to the adjuster and the supervisor, then (if that still doesn’t receive attention) to the adjuster, the supervisor, and the supervisor’s supervisor, in every case informing all parties who's been CC'd on the communication.
If you still aren't getting attention for your claim, then it’s time for you to turn it over to a personal injury lawyer. But all these letters are not wasted effort: they will serve as documentation of good faith on your part, and will be valuable evidence against the insurance company in a trial or settlement negotiation.